AAP Voices Blog

In early April 2020, general pediatrics night call was different. We pediatricians were vigilant to keep kids safe at home. 

But unexpectedly, on many calls, I told families that they needed to go to the ER. “Yes, your child is severely concussed, he needs to be seen.” “Yes, your daughter’s ear laceration will need stitches. She will be safe in the ER.”

But there was another change. 

One mom explained to me how her toddler had giant tonsils, with one side bigger and pressing into the other side. He could move his neck, wasn’t drooling and happily ate everything. 

Her partner had received COVID testing that morning. Differentials ran through my head: retropharyngeal abscess, peritonsillar abscess, foreign body? I wanted this child examined tonight. Considering my options, I recognized another difference: video visits were now permissible.

Mom consented and I quickly set up the video. In a matter of moments, I began chatting with a caring mother and her perky 2-year-old bouncing around her. 

He played peek-a-boo and easily moved his neck. Then came the climactic moment: I was armed with a small toy frog that opened its mouth. Mother wielded a flashlight and years of expertise with the phone’s camera. 

Two practice attempts later, the boy proudly, and widely, opened his mouth. Symmetric tonsils, uvula midline, no exudate and moist mucous membranes. 

I praised the boy for his excellent cooperation and reassured the mother: care at home for tonight.

And, in that moment, telehealth had forever changed my practice. 

Now, triaging “sick or not sick” can start from the virtual “doors” of our devices. And, when safe, with telehealth we can provide efficient, quality care within the medical home.

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*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.